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The Changing Face of Cancer at Work

Steve Jobs' public fight against pancreatic cancer is symbolic of how increasingly common it is to maintain a career while undergoing treatment. Here, cancer experts and survivors share the challenges and surprising benefits to working with cancer.

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If there’s one lesson we can learn from Apple co-founder and former chief executive Steve Jobs, it’s that advances in treatment have made it possible for many with serious cancers to not only live longer but continue working at a high level while they’re undergoing treatment.

Despite his recent resignation as Apple’s CEO, Jobs, 56, has been seemingly unstoppable since his 2004 diagnosis with a rare form of pancreatic cancer called pancreatic neuroendocrine cancer. Over the past seven years, Jobs has had surgery, chemotherapy, and radiation treatment; undergone a liver transplant; reportedly traveled to Switzerland to receive treatment not yet approved in the United States; and taken three medical leaves. And during that time he has also launched game-changing products that most of us can’t imagine a world without: iMac (2004), MacBook Pro (2008), iPhone (2008), iPod nano (2008), iPhone (2010), IPad (2011).

While this type of business genius is admittedly rare, it is not unusual to maintain a career while undergoing cancer treatment. According to the information clearinghouse Cancer and Careers, more than 80 percent of cancer patients return to work after treatment. “The perception of cancer has changed,” explains Kate Sweeney, executive director of the Cosmetic Executive Women Foundation, who has played a vital role in launching and developing the Cancer and Careers program. “Ten years ago, when we first launched Cancer and Careers, people thought that cancer was a death sentence. Today, more and more people are able to work during and shortly after their cancer treatment, thanks to earlier detection. ALSO, more targeted treatments have fewer devastating side effects, and there are more flexible treatment options like oral chemotherapies that can be taken at home. It is so much more common for people to know someone with cancer who has not only survived but returned to work. So those patients have examples to follow.”

Sweeney also attributes the high percentage of cancer patients in the workforce to the growing number of cancer organizations as well as federal and state laws that make it easier for cancer patients to stay employed.

“Most of my patients are still working or going to school, and are able to function very well,” says Edward M. Wolin, MD, co-director of the Carcinoid and Neuroendocrine Tumor Program at Cedars-Sinai Medical Center in Los Angeles. “The goal in treating a chronic illness like cancer is to maintain a high enough quality of life where you can still combine work, life, and family life.” Of course, a person’s capacity to work during and after a cancer diagnosis and treatment depends on the type and stage of their cancer, as well as the particular treatment they get and their overall health.

Upholding a strenuous schedule and career during cancer treatment — whether surgery, chemotherapy, radiation, or a combination of cancer therapies — is a constant challenge, says Dr. Wolin. Not only are patients running back and forth to doctor visits, but they’re also dealing with emotional and physical setbacks. Fatigue, for example, is common no matter what type of cancer therapy you undergo, and it is often so severe that it’s difficult to get out of bed, much less put in a full day’s work. Other common side effects include nausea and vomiting, anemia, skin changes, diarrhea or constipation, compromised immunity, loss of appetite, lack of concentration, depression, and anxiety.

In addition, some cancer survivors keep their diagnosis and treatment secret out of fear of getting fired or being treated differently by coworkers. Despite all of the advances and awareness surrounding cancer, there’s still some stigma attached to it. “When people hear cancer diagnosis they automatically ask, ‘How long do you have to live?’ ‘What’s the life expectancy?’" Wolin explains. “When someone has a heart attack or diabetes no one asks these questions.”

Yet despite the challenges of working with cancer, many survivors say employment helps keeps them going. “Work can be an important respite from the doctor’s appointments and tests,” explains Sweeney. “People tell us it’s an escape from ‘cancerland’ and that they just ‘didn’t want to sit around and think about their cancer all day.’”

Emily Westfal, 30, a social worker and triathlete who is currently in remission from stage 3b colon cancer agrees: “You need to feel like you’re doing something besides worrying about yourself — you can do that all day long.”

Mickey Scherl, 78, a retired social worker and volunteer at the American Cancer Society, who has been treated for cancer (breast and ovarian) seven times, missed only nine days of work during her first course of chemo in 1991. Still undergoing treatment today, Scherl says that her job helping newly diagnosed women with cancer has been her saving grace. “I thought cancer was a death sentence. Instead of a death sentence, ACS handed me a passport to a new life.”

For Everyday Health blogger Suzette Lipscomb, who is now cancer-free after two bouts of aggressive ductal breast cancer (in 2002 and 2008), not working was not an option. “It was either work or move home to my parents’ house and give up my business [a mortgage and construction company] that I worked so hard to create.”

And let’s face it: Treating cancer is costly. Even with health insurance — which can be prohibitively expensive without a job — patients may still face high out-of-pocket costs for prescriptions, doctor visits, and treatments.

But self employment also gave Lipscomb a sense of purpose and the motivation to stay positive. “Having to focus outward keeps the ‘all about me and my cancer syndrome’ at bay,” she explains. “People are counting on you so [you can’t] fall into a deep, self-focused despair. The world still spun and life continued while I went through treatment.”

Managing Cancer and Your Career

If you or someone you know is working through or after cancer treatment, consider these tips from the American Cancer Society to help you juggle the demands of work and recovery:

Read up on your rights. Educate yourself on your rights before telling your employer of your health status. The Americans with Disabilities Act (ADA) protects you if cancer limits any of your major life activities. For example, if you’re already employed, your employer can ask you about your health, but can't take your job away or treat you differently because you have cancer.

Know your limitations. Don’t overdo it. Listen to your body’s cues. Westfal recalls feeling like “Wonder Woman” the first day back at work, until she pushed too hard and literally had to run back to her office to vomit.

Be smart about treatment. Try to schedule chemotherapy or radiation treatments late in the day or right before the weekend to allow ample recovery time. Most people with cancer experience fatigue, which is especially common during and just after cancer treatment.

Consider a flexible work schedule. If possible, plan to reduce your hours or work from home once in a while. This can help reduce fatigue and will give you more time to take care of yourself.

Ask for help at home. Parceling out household chores among family and friends can help give you more energy for work. And don’t forget to ask for emotional support, too. Scherl says she wouldn’t have made it to age 78 without ongoing reassurance from her husband.

Share your diagnosis. Tell co-workers about your situation. They can be a great source of support and may even help you better manage your workload. “My co-workers were as supportive as my family members,” says Westfal.

Stay organized. Keep a detailed list of your job duties so it’s easier for others to handle things if you’re unexpectedly out of the office.